Are pre-employment and periodic medical examinations required for workers in Australia?

Not as a general rule. The model Work Health and Safety (WHS) laws do not require pre-employment or periodic medical examinations for all workers. They require health monitoring where workers are exposed to specific hazards: listed hazardous chemicals, lead and asbestos. Other examinations are a matter for the employer's risk management, industry rules or contracts.

Short answer

• General duty: the person conducting a business or undertaking (PCBU) must ensure, so far as is reasonably practicable, that workers' health and workplace conditions are monitored to prevent illness or injury (WHS Act, section 19(3)(g)).
• Mandatory health monitoring: ongoing work with a significant exposure risk to a Schedule 14 chemical (for example benzene, cadmium, crystalline silica, isocyanates, inorganic mercury), lead risk work, and licensed asbestos removal work or other ongoing asbestos removal or asbestos-related work with a risk of exposure.
• Who: by or under the supervision of a registered medical practitioner with experience in health monitoring, chosen in consultation with the worker; the PCBU pays.
• Records: confidential, kept at least 30 years (40 years for asbestos), not disclosed without the worker's written consent except as the regulations allow (regulations 378, 418 and 444).
• Victoria: employers must monitor the health of employees so far as is reasonably practicable (OHS Act 2004, section 22(1)).
• Coal mining and some other sectors have their own health assessment schemes under mining law; check the mining regulator.

When health monitoring is mandatory

Under regulation 368 of the Commonwealth WHS Regulations 2011, health monitoring is required when a worker carries out ongoing work using, handling, generating or storing hazardous chemicals and there is a significant risk to health from exposure to a chemical in Schedule 14, table 14.1. It is also required for other hazardous chemicals where valid tests for health effects or biological exposure exist and it is uncertain whether the biological exposure standard is exceeded. Workers must be told about the monitoring before they start the work (regulation 369).

The listed tests are the minimum type; an equal or better type may be used if the registered medical practitioner recommends it (regulation 370). The practitioner's report to the PCBU states any sign of work-related disease and any recommended remedial measures, including whether the worker can continue the work (regulation 374). The PCBU gives the worker a copy, and sends it to the regulator if it shows possible work-related disease or recommends remedial measures (regulations 375 and 376).

Other examinations and fitness for work

Pre-employment medicals, drug and alcohol testing and fitness-for-duty assessments are common in mining, transport and construction, but they come from risk management, industry-specific laws, licences (for example drivers and some plant operators) or enterprise agreements rather than from a general WHS requirement. Such assessments must also respect privacy and anti-discrimination law; the medical decision on fitness belongs to the examining practitioner.

Comparison with Türkiye and the EU

Türkiye requires examinations for all workers under Article 15 of Law No. 6331: at recruitment, on a change of job, on request after repeated absences for health reasons, and periodically at intervals set by the Ministry according to the hazard class. Reports come from the occupational physician, or for less hazardous workplaces with fewer than 50 workers also from public providers or family physicians, and the employer pays. EU law requires health surveillance appropriate to the risks (Framework Directive 89/391/EEC) and specific monitoring under daughter directives (for example chemical agents including lead, asbestos and noise). Australia is closest to the EU model, with a fixed list of hazards.

Common mistakes

• Sending every new worker to a general medical and calling it health monitoring. Monitoring must match the hazard and Schedule 14.
• Keeping health monitoring reports in the general HR file. They are confidential medical records, kept 30 years (asbestos 40).
• Forgetting the 1-month follow-up test for new lead workers.

Related on excodex

• Occupational safety and health in Australia: law, authorities and employer duties
• Must an employer in Australia appoint a safety professional or an occupational physician?
• Health surveillance and medical examinations: tests by exposure

Standards and further reading

• Work Health and Safety Act 2011 (Cth), section 19(3)(g): https://www.legislation.gov.au/C2011A00137/latest/text
• Work Health and Safety Regulations 2011 (Cth), regulations 368 to 378, 405 to 418, 435 to 444 and Schedule 14: https://www.legislation.gov.au/F2011L02664/latest/text
• Occupational Health and Safety Act 2004 (Vic), section 22: https://www.legislation.vic.gov.au/in-force/acts/occupational-health-and-safety-act-2004
• Law No. 6331 on Occupational Health and Safety (Türkiye), Article 15

This article is general occupational safety and health information prepared by the excodex editorial team. It does not replace the applicable legislation, standards, manufacturers' instructions or the assessment of a competent OSH professional or occupational physician.